MICHELLE ROSE WILLENBRING OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931120

License Status

CANCELLED

Business

First Name

MICHELLE

Middle

ROSE

Last Name

WILLENBRING

Suffix

Business Name

MICHELLE ROSE WILLENBRING OD

Original Issue Date

04/21/2005

Effective Date

04/30/2008

Expiration Date

03/31/2010

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/04/2010